Friday, March 29, 2019
Elective Cesarean Section Procedure Health And Social Care Essay
electoral Ces aran Section Procedure wellness And Social C are EssayCesarean sections, once performed to save the deportment of mother or mar, are now offered as an elective result. Women spot elective cesarian sections in the belief that the cognitive operation is safe and vaginal parturition poses risk of harm to themselves or their child. A look at studies and literature shows that these unwanted consequences of vaginal delivery result from the aggressive focusing of campaign by obstetricians. Rather than resorting to major surgery, a return to the tocology model of care will earn mother and babies in low-risk pregnancies.Elective Cesarean SectionOnce reserved as a procedure of last resort to save the life of mother or baby, caesarean delivery section (CS) surgery is now offered as an elective procedure to mothers who entreat to avoid the experience of labor and delivery. The American College of Obstetricians and Gynecologists (ACOG) published a citizens committee opinion in November 2003 supporting the permissibility of elective cesarean delivery in a normal pregnancy, subsequently adequate informed consent(American College of Obstetricians and Gynecologists ACOG, p. 1101). Women may recognise this option in the belief that circumventing vaginal delivery preserves the lawfulness of their pelvic floor, or provides better cores for their children. Although some believe contain by elective cesarean section (ECS) is preferable to vaginal brook, it can be shown that in low-risk pregnancies, vaginal induce is safer for both mother and baby.Supporters of ECS believe vaginal delivery results in equipment casualty to the pelvic floor, which may lead to urinary incontinence (UI), anal incontinence, sexual dysfunction, or pelvic organ prolapsed (Nygaard Cruikshank, 2003). thither are studies that support this belief. In one study of primiparous women 26 percent had incontinence at six months postpartum, the rate being utmost with elective c esarean (five percent), higher with cesarean during labour (twelve percent), higher calm down following a spontaneous vaginal pedigree (twenty-two percent) and highest following a vaginal forceps delivery (thirty-three percent) (Hannah, 2004, p. 813). The physicians that champion the cause of ECS and the women who buy into their sales delivery for ECS believe they are preventing this damage.However, an ECS may not guarantee prevention of pelvic floor damage, and its benefits are at best short- landmark. Some women who undergo ECS post from incontinence, conjureing pregnancy itself, aprospicient with hereditary indications, are risk factors (Leeman, 2005 Nygaard Cruikshank, 2003). Other studies signalize there are no significant differences between the vaginal parenthood and CS groups at two years postpartum (Goer, 2001). Buschsbaum, Chin, Glantz, and Guzick (2002) found no significant differences exist in the prevalence of UI between nulliparous and parous women after menopa use. Before we point the finger at the natural process of vaginal delivery as the cause of this pelvic floor damage, we should look at the interventions that may cause these problems.Goer (2001) suggests obstetric interventions of second stage labor, not vaginal birth, causes damage to the pelvic floor. Obstetric guidance such as episiotomies, forceps and vacuum extractions, dorsal lithotomy position, and the Valsalva maneuver may be the cause of the pelvic floor compromise the ECS supporters are concerned close. Goer suggests using tumid positions for pushing, following the patients natural urges to push, and elimination of routine episiotomies to decrease the damage to the pelvic floor. If she is correct, and alterations in routine obstetric care remove the concern of pelvic floor damage, then the recourse of the baby becomes the cry of ECS supporters.The ECS supporters argue the safety issue with multiple vociferations for the protective value of skipping labor and vaginal d elivery. They claim we can preemptively protect the fetus by CS prior to the plan of attack of labor. This protection can include the reduction of stillbirth related to post-maturity, damage from oxygen deprivation secondary to cord compression during labor and delivery, and birth trauma related to use of forceps or vacuum extraction (Armson, 2007). For mothers with medical conditions or the compromised fetus, a scheduled CS is a valid option. However, labor and vaginal delivery is a natural, generally safe, process, not something from which the low-risk fetus require protection.Those opposed to ECS believe risks to the infant from vaginal birth are minimum and unfavorable foetal outcomes rare, however, we may be increasing risks due to excess obstetrical interventions during labor and birth. For the low-risk patient, the increase in maternal unwholesomeness and deathrate (Armson, 2007) resulting from major surgery does not justify the possibility of preventing the rare adver se fetal outcome. Better screening of those patients at risk will decent identify those patients who would legitimately benefit from surgery. Similar to the suggestion that obstetric management causes damage to the mothers pelvic floor, Goer (2001) argues that obstetric interventions also put the baby at risk. In first stage labor these interventions include oxytocin augmentation and artificial rupture of membranes. In second stage labor, the same interventions that suffer the mother, such as forceps, vacuum extraction, and sustained Valsalva maneuver, cause trauma for the infant. She suggests patience, tranquillise management of labor and delivery, and respect for mothers natural pushing ability to edit injury to the infant. vaginal delivery with minimal interventions does not need to be headacheed.Despite improvements in the safety of CS over the years, vaginal birth remains safer than a CS for both mother and baby in low-risk pregnancies. In contrast to ACOGs committee opini on, The American College of Nurse-Midwives Identifies vaginal birth as the optimal mode of birth for women and their babies and this practice cesarean section is not supported by scientific evidence (American College of Nurse-Midwives, 2005). Cesarean sections carry significant risks to mother, baby, and interfere with the mother-baby dyad. little(a) term, vaginal birth is the safest choice for low-risk women, eliminating many of the complications inherent to a CS as listed by Armson (2007)The overall risk of severe maternal morbidity was 3.1 times that in the planned vaginal delivery group, including increased risks of postpartum cardiac arrest, wound hematoma, hysterectomy, major puerperal infection, anesthetic complications, venous thromboembolism and exhaust requiring hysterectomy . . . hemorrhage requiring transfusion, hysterectomy and uterine rupture intensive care admission and postpartum readmission to hospital (p. 475).Women who birth vaginally face fewer complications, le ave the hospital quicker, and make a shorter recovery time (Hannah, 2004). The benefits of vaginal birth are not limited to the immediate period of birth and postpartum.The choice between vaginal and CS impact the entire range of a womans childbearing years. prox labors tend to be shorter for women who birth vaginally. Their deliveries are quicker, and they are less probable to need a CS in the future. In comparison, internal pock tissue and adhesions following a CS increases risk factors for future pregnancies, single-handed of the future method of delivery (Leeman, 2006). These risks include infertility ectopic pregnancy miscarriage placenta abnormalities such as placenta previa or placenta acretia and complications of repeat cesarean birth (Armson, 2007, p. 475). Women with placental abnormities face higher maternal mortality and morbidity pass judgment (Lyerly Schwartz, 2004), as well as an increased need for hysterectomies (Armson, 2007). Primary cesarean birth is also a ssociated with increased risks in subsequent pregnancies of preterm delivery, low birth weight, stillbirth and neonatal death (Armson, 2007, p. 476). The mothers choices regarding mode of delivery lease foresighted reaching effects for herself, as well as the child that she carries.Vaginal birth is also the safest choice for babies, as they avoid many of the neonatal complications which follow pre-labor CS. These risks include respiratory problems, persistent pulmonary hypertension, asphyxia, delayed neurological adaptation and neonatal intensive care admission (Armson, 2007, p. 476). Many et al. (2006) suggest that the mechanism of labor benefits the babys respiratory system. Other complications CS babies face are iatrogenic prematurity (Lyerly Schwartz, 2004), and lacerations or other neonatal trauma during surgery (Armson, 2007). Babies born by CS also face long term health risks they are more likely to develop asthma, diabetes, food allergies and corpulency than vaginally bo rn children (Steer, 2009). The benefits to the mother and the baby as individuals also benefit the mother-baby unit.Finally, mother-baby couplets benefit from a vaginal birth in multiple ways. The natural hormonal rush which occurs in labor prepares a woman for breastfeeding and facilitates bonding. Women who birth vaginally have less discomfort and shorter recovery times following birth and are thus better able to care for, and bond with, their babies. This enhances mother-baby interaction and supports babys randy development. Breastfeeding rates are higher and depression rates are set about following vaginal birth (International Cesarean Awareness Network, 2008). These benefits extend long term they establish the foundation of the lifetime mother-child relationship.The decision to give birth by CS greatly affects mother, baby, and future pregnancies and should not be offered electively as if it were a minor cosmetic surgery. The benefits of ECS compared to vaginal birth have not been proven, and the risks are substantial to not just one, but two (or more) patients. Women may fear labor. Birth attendants may fear legal risks from adverse fetal outcomes. These fears do not exhibit that womens bodies are incapable of birthing rather, they indicate the failure of obstetric management of labor. We should not base our decisions on fear or faulty look.We should address the concerns of ECS proponents raise. We need to conduct more research into prevention of pelvic floor damage. The American College of Nurse-Midwives (2005) offers the follow guidelinesSupports womens right to accurate, fit and complete information regarding the risks and benefits of both vaginal birth and cesarean section.Promotes decision-making about mode of delivery that is evidence based and not unduly influenced by factors such as liability, convenience or economics.Supports further research to judge the short and long-term medical, psychosocial, economic and cultural sequelae for mother s, babies, including future pregnancies associated with elective primary(a) cesarean section.As birth attendants follow these guidelines, women will be empower to make informed decisions about their care. These decisions affect the physical and emotional health of these women and their children for a lifetime. We have an obligation to manage birth in a manner that causes the least harm to mother while providing the best outcome for babies.